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  1. Article ; Online: Hospital admissions following emergency medical services in Germany: analysis of 2 million hospital cases in 2022.

    Roessler, Martin / Schulte, Claudia / Bobeth, Christoph / Wende, Danny / Karagiannidis, Christian

    Medizinische Klinik, Intensivmedizin und Notfallmedizin

    2024  

    Abstract: Background: The use of emergency medical services (EMS) in Germany has increased substantially over the last few decades. While current reform efforts aim to increase effectiveness and efficiency of the German hospital and EMS systems, there is lack of ... ...

    Title translation Krankenhausaufnahmen nach Rettungsmitteln in Deutschland: Analyse von 2 Mio. Krankenhausfällen im Jahr 2022.
    Abstract Background: The use of emergency medical services (EMS) in Germany has increased substantially over the last few decades. While current reform efforts aim to increase effectiveness and efficiency of the German hospital and EMS systems, there is lack of data on characteristics of hospital cases using EMS.
    Objectives: To analyze and compare the characteristics of cases hospitalized with and without the use of EMS.
    Materials and methods: The BARMER health insurance data on more than 2 million hospital cases admitted in 2022 were analyzed. The distributions of age, clinical complexity (measured by patient clinical complexity levels, PCCL), main diagnoses, costs for EMS and hospital treatment, and multiple severity indicators were described. The overall severity of hospital cases was classified as "low or moderate" or "high" based on a combined severity indicator. All analyses were stratified by use of EMS and EMS type.
    Results: A total of 28% of all included hospital cases used EMS. Relative to hospital cases without use of EMS, hospital cases with use of EMS were older (physician-staffed ambulance: 75 years, interquartile range [IQR] 59-84, double-crewed ambulance: 78 years, IQR 64-85) and had a higher clinical complexity. The severity of more than 30% of the cases using EMS (except for patient transport service ambulance) was classified as "low or moderate". The distributions of main diagnoses differed by severity and use of EMS.
    Conclusions: The high proportion of cases with low or moderate severity using EMS may indicate a substantial potential to avoid the use of EMS in the context of hospital admissions in Germany. Further investigation is required to explore whether the proportion of cases using EMS could be reduced by optimizing preclinical service.
    Language English
    Publishing date 2024-04-23
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 2636018-4
    ISSN 2193-6226 ; 1435-1420 ; 0723-5003 ; 2193-6218 ; 0175-3851
    ISSN (online) 2193-6226 ; 1435-1420
    ISSN 0723-5003 ; 2193-6218 ; 0175-3851
    DOI 10.1007/s00063-024-01148-6
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  2. Article ; Online: New Physics constraints from rare b → s + (γ, ℓ+ℓ−) decays

    Bobeth Christoph

    EPJ Web of Conferences, Vol 49, p

    2013  Volume 13004

    Abstract: The experimental measurements of flavor-changing neutral-current B-meson decays governed by b → s + (γ, ℓ+ℓ−) transitions have entered a new level of precision. Recent results by Belle, CDF, Babar, and LHCb on B → K(*)ℓ+ℓ− and Bs → μ+μ− decays are used ... ...

    Abstract The experimental measurements of flavor-changing neutral-current B-meson decays governed by b → s + (γ, ℓ+ℓ−) transitions have entered a new level of precision. Recent results by Belle, CDF, Babar, and LHCb on B → K(*)ℓ+ℓ− and Bs → μ+μ− decays are used in model-(in)dependent analyses to test the Standard Model predictions and to derive stronger constraints on nonstandard contributions. While in agreement with the Standard Model, they still leave sizable room for new physics.
    Keywords Physics ; QC1-999 ; Science ; Q ; DOAJ:Physics (General) ; DOAJ:Physics and Astronomy
    Language English
    Publishing date 2013-05-01T00:00:00Z
    Publisher EDP Sciences
    Document type Article ; Online
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  3. Book ; Online: Searching for New Physics with $\overline{\mathcal{B}}(B_{s,d}\to\mu\bar\mu)/\Delta M_{s,d}$

    Bobeth, Christoph / Buras, Andrzej J.

    2021  

    Abstract: We reemphasize that the ratio $R_{s\mu} \equiv \overline{\mathcal{B}}(B_s\to\mu\bar\mu)/\Delta M_s$ is a measure of the tension of the Standard Model (SM) with latest measurements of $\overline{\mathcal{B}}(B_s\to\mu\bar\mu)$ that does not suffer from ... ...

    Abstract We reemphasize that the ratio $R_{s\mu} \equiv \overline{\mathcal{B}}(B_s\to\mu\bar\mu)/\Delta M_s$ is a measure of the tension of the Standard Model (SM) with latest measurements of $\overline{\mathcal{B}}(B_s\to\mu\bar\mu)$ that does not suffer from the persistent puzzle on the $|V_{cb}|$ determinations from inclusive versus exclusive $b\to c\ell\bar\nu$ decays and which affects the value of the CKM element $|V_{ts}|$ that is crucial for the SM predictions of both $\overline{\mathcal{B}}(B_s\to\mu\bar\mu)$ and $\Delta M_s$, but cancels out in the ratio $R_{s\mu}$. In our analysis we include higher order electroweak and QED corrections und adapt the latest hadronic input to find a tension of about $2\sigma$ for $R_{s\mu}$ measurements with the SM independently of $|V_{ts}|$. We also discuss the ratio $R_{d\mu}$ which could turn out, in particular in correlation with $R_{s\mu}$, to be useful for the search for New Physics, when the data on both ratios improves. Also $R_{d\mu}$ is independent of $|V_{cb}|$ or more precisely $|V_{td}|$.

    Comment: 14 pages, 2 figures; v2: updated experimental input and added discussion on top-quark-mass dependence, added references, conclusions unchanged
    Keywords High Energy Physics - Phenomenology ; High Energy Physics - Experiment ; High Energy Physics - Lattice
    Subject code 612
    Publishing date 2021-04-19
    Publishing country us
    Document type Book ; Online
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  4. Article: [No title information]

    Aebischer, Jason / Bobeth, Christoph / Buras, Andrzej J

    The European physical journal. C, Particles and fields

    2020  Volume 80, Issue 8, Page(s) 705

    Abstract: We reanalyse the ... ...

    Abstract We reanalyse the ratio
    Language English
    Publishing date 2020-08-06
    Publishing country France
    Document type Journal Article
    ZDB-ID 1459069-4
    ISSN 1434-6052 ; 1434-6044
    ISSN (online) 1434-6052
    ISSN 1434-6044
    DOI 10.1140/epjc/s10052-020-8267-1
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  5. Article ; Online: Treatment in certified cancer centers is related to better survival in patients with colon and rectal cancer: evidence from a large German cohort study.

    Bierbaum, Veronika / Bobeth, Christoph / Roessler, Martin / Gerken, Michael / Tol, Kees Kleihues-van / Reissfelder, Christoph / Fürst, Alois / Günster, Christian / Dröge, Patrik / Ruhnke, Thomas / Klinkhammer-Schalke, Monika / Schmitt, Jochen / Schoffer, Olaf

    World journal of surgical oncology

    2024  Volume 22, Issue 1, Page(s) 11

    Abstract: Background: Certified cancer centers aim to ensure high-quality care by establishing structural and procedural standards according to evidence-based guidelines. Despite the high clinical and health policy relevance, evidence from a nation-wide study for ...

    Abstract Background: Certified cancer centers aim to ensure high-quality care by establishing structural and procedural standards according to evidence-based guidelines. Despite the high clinical and health policy relevance, evidence from a nation-wide study for the effectiveness of care for colorectal cancer in certified centers vs. other hospitals in Germany is still missing.
    Methods: In a retrospective cohort study covering the years 2009-2017, we analyzed patient data using demographic information, diagnoses, and treatments from a nationwide statutory health insurance enriched with information on certification. We investigated whether patients with incident colon or rectal cancer did benefit from primary therapy in a certified cancer center. We used relative survival analysis taking into account mortality data of the German population and adjustment for patient and hospital characteristics via Cox regression with shared frailty for patients in hospitals with and without certification.
    Results: The cohorts for colon and rectal cancer consisted of 109,518 and 51,417 patients, respectively, treated in a total of 1052 hospitals. 37.2% of patients with colon and 42.9% of patients with rectal cancer were treated in a certified center. Patient age, sex, comorbidities, secondary malignoma, and distant metastases were similar across groups (certified/non-certified) for both colon and rectal cancer. Relative survival analysis showed significantly better survival of patients treated in a certified center, with 68.3% (non-certified hospitals 65.8%) 5-year survival for treatment of colon cancer in certified (p < 0.001) and 65.0% (58.8%) 5-year survival in case of rectal cancer (p < 0.001), respectively. Cox regression with adjustment for relevant covariates yielded a lower hazard of death for patients treated in certified centers for both colon (HR = 0.92, 95% CI = 0.89-0.95) and rectal cancer (HR = 0.92, 95% CI = 0.88-0.95). The results remained robust in a series of sensitivity analyses.
    Conclusions: This large cohort study yields new important evidence that patients with colorectal cancer have a better chance of survival if treated in a certified cancer center. Certification thus provides one powerful means to improve the quality of care for colorectal cancer. To decrease the burden of disease, more patients should thus receive cancer care in a certified center.
    MeSH term(s) Humans ; Cohort Studies ; Retrospective Studies ; Rectal Neoplasms/therapy ; Certification ; Colon
    Language English
    Publishing date 2024-01-06
    Publishing country England
    Document type Journal Article
    ZDB-ID 2118383-1
    ISSN 1477-7819 ; 1477-7819
    ISSN (online) 1477-7819
    ISSN 1477-7819
    DOI 10.1186/s12957-023-03262-9
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  6. Book ; Online: Theory status of $b\to s \ell^+\ell^-$ decays and their combined analysis

    Bobeth, Christoph

    2012  

    Abstract: The experimental information on b --> s l^+ l^- decays has grown enormously during the last couple of years due to BaBar, Belle, CDF and LHCb. Especially, exclusive modes B --> K^(*) l^+ l^-, which have the largest rate and are easily accessible ... ...

    Abstract The experimental information on b --> s l^+ l^- decays has grown enormously during the last couple of years due to BaBar, Belle, CDF and LHCb. Especially, exclusive modes B --> K^(*) l^+ l^-, which have the largest rate and are easily accessible experimentally, provide a variety of observables which constrain non-standard interactions that would affect these flavour-changing neutral current decays beyond the Standard Model. Nowadays, theoretical predictions focus on low- and high dilepton invariant mass regions, where expansions in Lambda_QCD/m_b and form factor symmetries provide means to identify optimised observables. The first experimental results of non-optimised observables have stimulated first global analysis of b --> s l^+ l^- decays in combination with b --> s photon and B_s --> mu^+ mu^-. Such global analysis are now ready to be applied to include high-statistics results from LHCb and Super-Flavour factories which are about to come within the next years.

    Comment: To appear in the proceedings of the conference 'Heavy Quarks and Leptons 2012', June 11-15, Prague, 9 pages, 1 figure
    Keywords High Energy Physics - Phenomenology
    Subject code 306
    Publishing date 2012-08-15
    Publishing country us
    Document type Book ; Online
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  7. Article ; Online: Enhanced Electromagnetic Corrections to the Rare Decay B_{s,d}→μ^{+}μ^{-}.

    Beneke, Martin / Bobeth, Christoph / Szafron, Robert

    Physical review letters

    2018  Volume 120, Issue 1, Page(s) 11801

    Abstract: We investigate electromagnetic corrections to the rare B-meson leptonic decay B_{s,d}→μ^{+}μ^{-} from scales below the bottom-quark mass m_{b}. Contrary to QCD effects, which are entirely contained in the B-meson decay constant, we find that virtual ... ...

    Abstract We investigate electromagnetic corrections to the rare B-meson leptonic decay B_{s,d}→μ^{+}μ^{-} from scales below the bottom-quark mass m_{b}. Contrary to QCD effects, which are entirely contained in the B-meson decay constant, we find that virtual photon exchange can probe the B-meson structure, resulting in a "nonlocal annihilation" effect. We find that this effect gives rise to a dynamical enhancement by a power of m_{b}/Λ_{QCD} and by large logarithms. The impact of this novel effect on the branching ratio of B_{s,d}→μ^{+}μ^{-} is about 1%, of the order of the previously estimated nonparametric theoretical uncertainty, and four times the size of previous estimates of next-to-leading order QED effects due to residual scale dependence. We update the standard model (SM) prediction to B[over ¯](B_{s}→μ^{+}μ^{-})_{SM}=(3.57±0.17)×10^{-9}.
    Language English
    Publishing date 2018-01-05
    Publishing country United States
    Document type Journal Article
    ZDB-ID 208853-8
    ISSN 1079-7114 ; 0031-9007
    ISSN (online) 1079-7114
    ISSN 0031-9007
    DOI 10.1103/PhysRevLett.120.011801
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  8. Article: Treatment in Certified Breast Cancer Centers Improves Chances of Survival of Patients with Breast Cancer: Evidence Based on Health Care Data from the WiZen Study.

    Schoffer, Olaf / Wimberger, Pauline / Gerken, Michael / Bierbaum, Veronika / Bobeth, Christoph / Rößler, Martin / Dröge, Patrik / Ruhnke, Thomas / Günster, Christian / Kleihues-van Tol, Kees / Link, Theresa / Scharl, Anton / Inwald, Elisabeth C / Kast, Karin / Papathemelis, Thomas / Ortmann, Olaf / Klinkhammer-Schalke, Monika / Schmitt, Jochen

    Geburtshilfe und Frauenheilkunde

    2024  Volume 84, Issue 2, Page(s) 153–163

    Abstract: Introduction: Certified breast cancer centers offer specific quality standards in terms of their structure, diagnostic and treatment approaches with regards to breast surgery, drug-based cancer therapy, radiotherapy, and psychosocial support. Such ... ...

    Abstract Introduction: Certified breast cancer centers offer specific quality standards in terms of their structure, diagnostic and treatment approaches with regards to breast surgery, drug-based cancer therapy, radiotherapy, and psychosocial support. Such centers aim to improve treatment outcomes of breast cancer patients. The question investigated here was whether patients with primary breast cancer have a longer overall survival if they are treated in a certified breast cancer center compared to treatment outside these centers.
    Methods: We used patient-specific data (demographics, diagnoses, treatments) obtained from data held by mandatory health insurance companies (
    Results: The sample population consisted of 143720 (GKV data) and 59780 (KKR data) patients with breast cancer, who were treated in 1010 hospitals across Germany (280 DKG-certified, 730 not DKG-certified). 63.5% (GKV data) and 66.7% (KKR data) of patients, respectively, were treated in DKG-certified breast cancer centers. Cox regression analysis for overall survival which included patient and hospital characteristics found a significantly lower mortality risk for patients treated in DKG-certified breast cancer centers (GKV data: HR = 0.77, 95% CI = 0.74-0.81; KKR data: HR = 0.88, 95% CI = 0.85-0.92). This result remained stable even after several sensitivity analyses including stratified estimates for subgroups of patients and hospitals. The effect was even more pronounced for recurrence-free survival (KKR data: HR = 0.78, 95% CI = 0.74-0.82).
    Conclusions: Patients who are treated by an interdisciplinary team in a DKG-certified breast cancer had clear and statistically significantly better survival rates. Certification is therefore an effective means of improving the quality of care, and more patients should be treated in certified breast cancer centers.
    Language English
    Publishing date 2024-01-09
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 80111-2
    ISSN 1438-8804 ; 0016-5751 ; 1615-3359
    ISSN (online) 1438-8804
    ISSN 0016-5751 ; 1615-3359
    DOI 10.1055/a-1869-1772
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  9. Article ; Online: Methodik und Zuordnungserfolg eines Linkage von Daten klinischer Krebsregister mit Abrechnungsdaten gesetzlicher Krankenkassen.

    Bobeth, Christoph / Tol, Kees Kleihues-van / Rößler, Martin / Bierbaum, Veronika / Gerken, Michael / Günster, Christian / Dröge, Patrik / Ruhnke, Thomas / Klinkhammer-Schalke, Monika / Schmitt, Jochen / Schoffer, Olaf

    Gesundheitswesen (Bundesverband der Arzte des Offentlichen Gesundheitsdienstes (Germany))

    2023  Volume 85, Issue S 02, Page(s) S154–S161

    Abstract: Background: The aim of the project "Effectiveness of care in oncological centres" (WiZen), funded by the innovation fund of the federal joint committee, is to investigate the effectiveness of certification in oncology. The project uses nationwide data ... ...

    Title translation Methodology and Attribution Success of a Data Linkage of Clinical Registry Data with Health Insurance Data.
    Abstract Background: The aim of the project "Effectiveness of care in oncological centres" (WiZen), funded by the innovation fund of the federal joint committee, is to investigate the effectiveness of certification in oncology. The project uses nationwide data from the statuory health insurance AOK and data from clinical cancer registries from three different federal states from 2006-2017. To combine the strengths of both data sources, these will be linked for eight different cancer entities in compliance with data protection regulations.
    Methods: Data linkage was performed using indirect identifiers and validated using the health insurance's patient ID ("Krankenversichertennummer") as a direct identifier and gold standard. This enables quantification of the quality of different linkage variants. Sensitivity and specificity as well as hit accuracy and a score addressing the quality of the linkage were used as evaluation criteria. The distributions of relevant variables resulting from the linkage were validated against the original distributions in the individual datasets.
    Results: Depending on the combination of indirect identifiers, we found a range of 22,125 to 3,092,401 linkage hits. An almost perfect linkage could be achieved by combining information on cancer type, date of birth, gender and postal code. A total of 74,586 one-to-one linkages were achieved with these characteristics. The median hit quality for the different entities was more than 98%. In addition, both the age and sex distributions and the dates of death, if any, showed a high degree of agreement.
    Discussion and conclusion: SHI and cancer registry data can be linked with high internal and external validity at the individual level. This robust linkage enables completely new possibilities for analysis through simultaneous access to variables from both data sets ("the best of both worlds"): Information on the UICC stage that stems from the registries can now be combined, for instance, with comorbidities from the SHI data at the individual level. Due to the use of readily available variables and the high success of the linkage, our procedure constitutes a promising method for future linkage processes in health care research.
    MeSH term(s) Humans ; Routinely Collected Health Data ; Germany/epidemiology ; Registries ; Information Storage and Retrieval ; Insurance, Health ; Neoplasms/epidemiology ; Medical Record Linkage/methods
    Language German
    Publishing date 2023-03-20
    Publishing country Germany
    Document type English Abstract ; Journal Article
    ZDB-ID 1101426-x
    ISSN 1439-4421 ; 0941-3790 ; 0949-7013
    ISSN (online) 1439-4421
    ISSN 0941-3790 ; 0949-7013
    DOI 10.1055/a-1984-0085
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  10. Article ; Online: Initial Cancer Treatment in Certified Versus Non-Certified Hospitals.

    Schmitt, Jochen / Klinkhammer-Schalke, Monika / Bierbaum, Veronika / Gerken, Michael / Bobeth, Christoph / Rößler, Martin / Dröge, Patrik / Ruhnke, Thomas / Günster, Christian / Kleihues-van Tol, Kees / Schoffer, Olaf

    Deutsches Arzteblatt international

    2023  Volume 120, Issue 39, Page(s) 647–654

    Abstract: Background: According to the National Cancer Plan in Germany, all cancer patients should receive high-quality care in accordance with evidence-based treatment guidelines. Certification programs were established for this purpose but have not yet been ... ...

    Abstract Background: According to the National Cancer Plan in Germany, all cancer patients should receive high-quality care in accordance with evidence-based treatment guidelines. Certification programs were established for this purpose but have not yet been comprehensively evaluated.
    Methods: In the WiZen project, which was supported by the Innovation Fund (supported project number 01VSF17020), controlled cohort studies were performed to investigate whether initial treatment in hospitals with or without a certificate from the German Cancer Society was associated with a difference in overall survival (primary endpoint) in patients with cancer of the colon, rectum, lung, pancreas, breast, cervix, prostate, endometrium, and ovary, head and neck cancer, and neuro-oncological tumors. The studies were based on nationwide data from adult insurees of the AOK statutory health insurance carrier for the years 2009-2017.
    Results: The majority of patients with all entities except breast cancer received their initial treatment in non-certified hospitals. Initial treatment in a certified hospital was found to be beneficial in terms of overall survival for all cancer entities, even after extensive adjustment for patient- and hospital-related confounders. The hazard ratio (HR) ranged from 0.97 (95% CI: [0.94; 1.00]) for lung cancer to 0.77 [0.74; 0.81] for breast cancer, corresponding to an absolute risk reduction (ARR) for overall survival of 0.62 months for lung cancer to 4.61 months for cervical cancer.
    Conclusion: The WiZen study shows for the entities studied that initial cancer treatment in a certified center is associated with lower mortality. Despite the recommendations of the National Cancer Plan, however, more than 40% of all cancer patients still receive their initial treatment in a non-certified hospital. The preferential provision of initial care in certified hospitals would be likely to improve overall survival. Although the study design does not permit any conclusion with regard to causality, the findings seem robust considering that a control group was used, confounders were taken into account, and the study population was of large size.
    MeSH term(s) Male ; Adult ; Female ; Humans ; Hospitals ; Head and Neck Neoplasms ; Breast Neoplasms/therapy ; Germany/epidemiology ; Lung Neoplasms ; Certification
    Language English
    Publishing date 2023-08-15
    Publishing country Germany
    Document type Observational Study ; Journal Article
    ZDB-ID 2406159-1
    ISSN 1866-0452 ; 1866-0452
    ISSN (online) 1866-0452
    ISSN 1866-0452
    DOI 10.3238/arztebl.m2023.0169
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